gum recession and I can see holes between my teeth

[kenny siu]

Hi I have gum recession and I can see ''holes'' between my compacted teeth. I am hesitating going for periodontal treatment (deep cleaning or depth pocket reduction) since I know more gum recession will follow. I am already depressed by the ''holes'' between my teeth I can see every day.

Is it possible that in the foreseen future, gum recession can be reversed?

 

[Zuri Barniv]

Gum recession cannot be reversed. I don't know if you really need periodontal treatment or not (because you may be told you do but you don't), but if you do, more recession may occur as a result of the gums shrinking. They shrink because they become healthier, which is good. If you do nothing, the disease will progress and eventually you will have even more recession. So I wouldn't delay treatment just to avoid recession, but I would take the time to figure out if it is really needed in the first place.
Dr. Barniv

 

[kenny siu]

Gum recession cannot be reversed. I don't know if you really need periodontal treatment or not (because you may be told you do but you don't), but if you do, more recession may occur as a result of the gums shrinking. They shrink because they become healthier, which is good. If you do nothing, the disease will progress and eventually you will have even more recession. So I wouldn't delay treatment just to avoid recession, but I would take the time to figure out if it is really needed in the first place.
Dr. Barniv

Hi doctor, this is exactly what annoying me. I don't know if I really needed the deep cleaning treatment. The periodontist said YES, but the dentists (many dentists) said NO.

Is it because deep cleaning can be replaced by simple routine cleaning in most cases??

Assume that I don't really need deep cleaning (since many dentists said NO), but I still do it at last to be safe--- Will I still have gum recession? or will the gum recession be ' less '

 

[Zuri Barniv]

Don't ever do a potentially unnecessary procedure to "be safe" because every procedure carries risk. There are several bad outcomes that are possible from an unnecessary deep cleaning. I would consult another periodontist or you can decide to trust one doctor if they give you good reasons to go one way or another. Bottom line: if you do a deep cleaning I don't think it will really affect gum recession one way or another long-term (in your case and based on what you told me). The things that cause gum recession are overly aggressive brushing, genetics and heavy teeth grinding.

 

[kenny siu]

Don't ever do a potentially unnecessary procedure to "be safe" because every procedure carries risk. There are several bad outcomes that are possible from an unnecessary deep cleaning. I would consult another periodontist or you can decide to trust one doctor if they give you good reasons to go one way or another. Bottom line: if you do a deep cleaning I don't think it will really affect gum recession one way or another long-term (in your case and based on what you told me). The things that cause gum recession are overly aggressive brushing, genetics and heavy teeth grinding.

Seriously, I have consulted three general dentists . And I consulted only one periodontist so far (since it's very expensive)
, he took x-ray and measured pocket depths for me. His comment was a kind of beginning periodontitis, since we didn't speak English and our language isn't very clear in these areas, I am not sure if he meant Gingivitis or early periodontitis.

Once again, I really can't figure out why the dentists and the periodontist said differently in terms of treatment. Dentists said simple scaling is already very enough for me. Periodontist said deep cleaning treatment is necessary, but not urgent. (I still don't understand what he meant by ''not urgent'' , he wants to make money out of deep cleaning, but he doesn't want to lie at the same time because of his profession? and so speaking unclearly?? )

What is your guess?
Is it likely that dentists were not serious enough and overlooked the problems? None of them took any x-ray or measured any pocket depths for me. They just looked at my teeth with naked eyes and a tool and concluded everything in less than a minute. Or is it because simple scaling at general dental office and good hygiene can already control periodontal disease for a lifetime?

In fact, can gingivitis or early periodontics be detected immediately, correctly, easily by a general dentist with naked eyes without looking at any x-ray or measuring any pocket depths?

Thanks again.

 

[Zuri Barniv]

You need to find a dentist who will evaluate you thoroughly and explain things clearly to you. Evaluating your gums properly cannot be done with the naked eye alone and certainly not in a minute or two. You need x-rays and measurements of pockets at a minimum. Early periodontitis is a slow process, don't let anyone rush you into treatment. Make sure you can change the things that may be causing it as well, this is as important as doing the treatment. I cannot diagnose your condition over a forum, but I can tell you that finding a conscientious and thorough general dentist is more important than getting a deep cleaning right now. A good dentist should make everything clear to you and give you the right advice on what to do.

 

[kenny siu]

I use another colour because I don't want to bore you with lengthy text.

Now, what I am hesitating is
1. As you said, is the deep cleaning treatment unnecessary? He also noted that he might open and close my gum for some teeth and sew the gum back, for better cleaning. However, it looks like most deep cleaning does not involve ''opening gum''. That's surgery mostly for advanced case.

2. I just saw your latest reply, x-ray and pocket depth measurements is a minimal for detection of periodontal disease right?

So, do you mean that the general dentists who didn't look at any x-ray or measure pocket depth for me and concluded that my teeth was fine and no periodontal disease and no deep cleaning was required, is lier or bullshitters??

The periodontist measured the pocket depths for me and said most teeth was 4 to 5 and a few of teeth (two or three teeth) reaching 7mm.

This is the full mouth x-ray taken at the periodontist

 

[kenny siu]

I'd like to make one more note here. I forgot to tell you that the last dentist I consulted had taken another full mouth x-ray for me but he measured some of the teeth for it's pocket depth. He spoken to the nurse for record and I heard the last word he told to the nurse was '' Moderate '' and completed the check.

Could he mean moderate periodontitis????

When he came back he just told me '' you have gum inflammation, cleaning will be offered when we call you, probably years later, get out of here '' (Governmental training school which does not provide treatment to patients as the main goal or as the first priority)

But he didn't mention if it's moderate periodontitis or not. And he didn't bother to explain me what the ''cleaning'' was and simply kicked my ass out of the room.

 

[Zuri Barniv]

This x-ray (panoramic) is not ideal for diagnosing gum disease but I basically understand the situation. I can't tell you about the morality of the other dentist's opinions, but I can tell you that in the State of California, the Standard of Care is that you need (at minimum) x-rays and pocket depths to diagnose gum disease. I would guess your deeper pockets are around your wisdom teeth. Since the bottom ones don't touch anything at all, just removing your 4 teeth would probably alleviate half the problem. I would consider that.

I don't want to dissuade you from doing necessary treatment so my original advice stands...you need to find a thorough and competent general dentist to help you.

 

[kenny siu]

This x-ray (panoramic) is not ideal for diagnosing gum disease but I basically understand the situation. I can't tell you about the morality of the other dentist's opinions, but I can tell you that in the State of California, the Standard of Care is that you need (at minimum) x-rays and pocket depths to diagnose gum disease. I would guess your deeper pockets are around your wisdom teeth. Since the bottom ones don't touch anything at all, just removing your 4 teeth would probably alleviate half the problem. I would consider that.

I don't want to dissuade you from doing necessary treatment so my original advice stands...you need to find a thorough and competent general dentist to help you.

Hi Doctor, thanks for your comments. Don't worry about dissuade... You don't bear any responsibility for me here. If the dentists I visited could reach the same conclusion, I would not have asked a lot of questions on different forums and be bothered with the problems for many weeks.

So don't worry ,please tell me more your guess, it won't dissuade me or persuade me. I have been trying to collect as much opinion as possible to see if I can make sense the whole thing on my own.

According to the x-ray, is there much bone loss at any site of my mouth??

 

[kenny siu]

removing my 4 teeth?? Do you mean removal of the four wisdom teeth? The two wisdom teeth on the upper jaw haven't emerged and only one and a half wisdom teeth have emerged for the lower jaw.

 

[Zuri Barniv]

I don't think I have any more information that could help you but I do not see severe bone loss in the x-ray. Some of the deeper pockets can specifically form around UNERUPTED or partially erupted wisdom teeth, so yes, removing all 4 of them may help your situation. Since you do not use them to chew, they will not be missed.

 

[kenny siu]

I don't think I have any more information that could help you but I do not see severe bone loss in the x-ray. Some of the deeper pockets can specifically form around UNERUPTED or partially erupted wisdom teeth, so yes, removing all 4 of them may help your situation. Since you do not use them to chew, they will not be missed.

Thanks Doctor

A couple more questions if you don't mind,

1. Two of the wisdom teeth (on the upper side) have not emerged, and the dentists believed that they might not emerge during my lifetime, can I ignore them if they do not emerge?

2. Would I feel pain or notice any symptoms to indicate that it's high time for extraction of wisdom teeth has come? Since I don't want to extract them now.

3. Would unextracted wisdom teeth worsen the periodontal disease?



BTW,

1. I have reverse bite , if I don't correct it , would it mean more likely loss of teeth in the future?
2. I also have buxism (grinding teeth during sleep), I have custom made a mouth guard, is it the ultimate solution to the problem?

 

[kenny siu]

What is the potential risks of over-treatment for periodontal disease except waste of money?

Deep cleaning treatment.


Thanks for all comments

 

[Zuri Barniv]

Pain, infection, abscess of a tooth, nerve injury and even the loss of a tooth as an end result of a bad outcome, they are rare but they exist. No treatment is without risk.

 

[kenny siu]

Pain, infection, abscess of a tooth, nerve injury and even the loss of a tooth as an end result of a bad outcome, they are rare but they exist. No treatment is without risk.

Thank you........